Joint Replacement and Antibiotic Prophylaxis

Have you had a joint replaced – A Hip? Knee? Does this mean that you need to have prophylactic antibiotics before undergoing dental treatment? Probably – but the American Dental Association (ADA) and the American Academy of Orthopaedic Surgeons (AAOS) are now working together to develop new evidence-based guidelines for antibiotic prophylaxis for dental patients who have total joint replacements. The new guidelines are expected to be available by 2011.

The previous guidelines issued in 2009 were inconclusive: “Given the potential adverse outcomes and cost of treating an infected joint replacement, the AAOS recommends that clinicians consider antibiotic prophylaxis for all total joint replacement patients prior to any invasive procedure that may cause bacteremia. ”Invasive dental procedures can cause bacterial invasion, so antibiotics need to be “considered” – and most cautious clinicians will recommend the antibiotics.

Prior to 2009 routine antibiotics were recommended only within the first two years following joint replacement and after that only for patients at increased risk. Confusing?You bet ya! For more information visit

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